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Organization

CANDACE MIZAUR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CANDACE MIZAUR PLMHP (OWNER)
(402) 807-0228
Entity
Organization

Contact information

Practice address
9819 S 168TH AVE STE 6F, OMAHA, NE 68136-1154
(402) 807-0228
Mailing address
9819 S 168TH AVE STE 6F, OMAHA, NE 68136-1154
(402) 807-0228

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
10/05/2023
Last updated
10/05/2023
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